(Reuters Health) - A combination of horseback riding and brain-building activities may help improve motor skills in children with neurodevelopmental conditions like autism-spectrum disorders and ADHD, a small study suggests.

The combination of approaches over several months appeared to produce measurable improvements in dexterity, coordination and strength, researchers report in Frontiers in Veterinary Science, and many parents noted their child showed behavioral improvements as well.

Coauthor B. Rhett Rigby of Texas Woman's University in Denton told Reuters Health by email that the study indicates, "outside of traditional gross and fine motor skills, behavioral and academic improvements may be observed by incorporating brain-building tasks before or after a child has participated in equine-assisted activities."

Neurodevelopmental disorders typically involve impairments in language and speech, cognition, behavior and motor skills, and children often exhibit problems related to personal, social and academic performance and functioning, the study authors note.

Past research has shown equine-assisted therapy, also known as hippotherapy, can help improve strength, dexterity, coordination and balance in children with autism spectrum disorder and ADHD, Rigby and colleagues note.

The current study explored whether adding a set of brain-building exercises to the equine-assisted therapy sessions made an additional difference.

Twenty-five children, ages 6 to 15, participated in the study at a local horse therapy facility over four 8-week periods. Their diagnoses included ADHD, autism spectrum disorder, intellectual development disorder, sensory processing disorder, global developmental delay and anxiety or mood disorder.

Before and after each of the four study segments, researchers tested the children's motor skills.

In the first 8-week period, the children went about their daily lives with no intervention. Next, they received 8 weeks of equine-assisted therapy activities only. The third 8-week period mimicked the first, with no interventions. And, in the final 8 weeks, the children performed both equine-assisted activities and brain-building tasks.

"With this research design, we were able to quantify contributions of their daily life, equine-assisted activities, and the brain-building activities to their overall motor skills," Rigby said.

During horseback riding sessions, children were taught horse anatomy, riding equipment and the basics of riding.

For the brain-building activities, children were given exercises that train the brain to process sensory information such as sound, sight, balance and spatial orientation. Sessions included music therapy and hand-eye coordination tasks.

"Horseback riding appeared to have improved balance, posture, and core strength in children with ADHD and ASD," Rigby said. In most measures, scores were higher after the combination of riding with brain building than after the riding alone.

The study wasn't designed to measure behavioral changes, but Rigby said parents provided "overwhelming" anecdotal evidence of positive differences on that front.

"These are things that are difficult to measure," Rigby said. "For example, the combination helped calm participants in social situations, increased their desire to initiate verbal conversations, helped some of them begin to read and elicited positive biopsychosocial changes including increased empathy, compliance and memory."

The results are preliminary, noted Robin Gabriels, program director for neuropsychiatric special care at Children's Hospital Colorado and a psychiatry professor at the University of Colorado Anschutz Medical Campus in Aurora.

"I look forward to the researchers conducting a randomized clinical trial to more definitively determine if equine-assisted activities combined with their curriculum effectively improves motor skills compared to therapeutic riding by itself," said Gabriels, who conducted the largest randomized controlled efficacy trial to date on the impacts of therapeutic horseback riding in youth with autism spectrum disorder.

The study authors agree that larger-scale research is needed. "With widespread acceptance and more rigorous research, equine-assisted activities and therapies may become more affordable and accessible," Rigby said.